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Connecting Wisconsin's Workforce

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Life Stress Questionnaire

Have you had any of the following things happen to you during the past year? If so, simply circle one of the numbers preceding each of those items. Score only the items which apply to you.

Point       Life 
Value      Event

15          Change in social activities

15          Change in sleeping habits

20          Change in residence

20          Change in work hours

20          Change in church activities

25          Tension at work

25          Small children in the home

25          Change in living conditions

30          Outstanding personal achievement

30          Problem teenager(s) in the home

30          Trouble with in-laws

30          Difficulties with peer group

30          Son or daughter leaving home

30          Change in responsibilities at work

30          Taking over major financial responsibility

30          Foreclosure of mortgage or loan

35          Change in relationship with spouse

35          Change to different line of work

35          Loss of a close friend

40          Gain of a new family member

40          Sexual difficulties

40          Pregnancy

45          Change in health of family member

45          Retirement

50          Loss of job

50          Change in quality of religious faith

50          Marriage

50          Personal injury or illness

60          Loss of self-confidence

60          Death of a close family member

60          Injury to reputation

65          Trouble with the law

65          Marital separation

75          Divorce

100         Death of a spouse

____        Grand total

Your total score measures the amount of stress to which you have been subjected.

Strategies to reduce stress physically and mentally.